Published on: 11 September 2019

The head and neck cancer team at Sunderland Royal Hospital will be highlighting the importance of HPV infection and the vaccination programme to prevent it during Head and Neck Cancer Awareness Week, September 16th to 20th*.

The annual event is central to the European Head and Neck Society’s Make Sense Campaign, which aims to raise awareness of head and neck cancer and, ultimately, improve outcomes for patients with the disease.

HPV, or Human papillomavirus, is the name given to a very common group of viruses, caught through any kind of sexual contact with another person who already has it. One in 10 people have active infection at any one time so most people will get an HPV infection at some point in their lives. Like many other viruses, usually their bodies will get rid of it naturally, however, some people infected with a high-risk type will not be able to clear it and, over time, this can cause abnormal tissue growth as well as other changes which can lead to cancer if not treated.   

Teenage girls in the UK have been able to have the HPV vaccine since 2008. From this month, all 12 and 13-year-olds in school year 8 – girls and boys – will be offered the vaccine.

Miss Helen Cocks, Consultant Head and Neck Surgeon at Sunderland Royal Hospital, said: “The vaccination programme was introduced initially to protect against cervical cancer but the same viruses can cause head and neck, anal or other genital cancers. Vaccination has already produced a significant reduction in cervical cancer and teenage viral genital warts in both sexes. Following on from programmes in some other countries such as Australia it was felt that a more significant eradication of viral infection and risk of these cancers could be achieved by vaccinating both sexes. To be effective, vaccination should commence before someone is sexually active.

“It takes on average around 20 years for someone to develop a cancer after HPV infection so it may be another decade or so until the impact of the vaccination programme is fully realised but HPV vaccination has so far been shown worldwide to work extremely well, decreasing the number of infections. We know that the connection between HPV and head and neck cancers is increasing in a younger demographic so we welcome this latest extension of the NHS HPV vaccination programme as it will help prevent more cases of HPV-related cancers from ever developing in boys as well as girls.”.

Around 12,000 new cases of head and neck cancer are diagnosed in the UK each year. Although not all are related to the HPV virus, there has been a huge increase in those that are virally-associated. Such cancers are most common in people over 40 years old. Men are two to three times more likely to develop head and neck cancer than women, though the incidence in women is increasing.

Miss Cocks said: “Head and neck cancer is approximately half as common as lung cancer and twice as common as cervical cancer but there is still comparatively little awareness of it. Yet, in many cases patients can be cured, particularly if they are diagnosed in the early stages. That is why education about disease prevention and about the signs and symptoms to encourage earlier presentation, diagnosis and referral for the right treatment is so vital. Indeed, head and neck cancer due to HPV is associated with a higher cure rate in most people than that due to other causes.”

HPV-related cancer classically affects where the back of the mouth joins the throat. In medical terms this is the oropharynx and includes the tonsils, the back (base) of the tongue and the soft palate. Apart from HPV infection, the main risk factors for head and neck cancer include smoking and alcohol.

There are more than 30 other areas within the head and neck where cancer can develop including:

  • the mouth and lips
  • voicebox (larynx)
  • lower throat (pharynx)
  • salivary glands
  • nose and sinuses
  • the back of the nose  

Signs and symptoms of head and neck cancer, which may vary according to the cancer site, include:

  • lump in the neck (swollen lymph nodes)
  • persistent hoarseness
  • persistent pain in the throat  with difficulty swallowing
  • non-healing mouth ulcers and/or red or white patches in the mouth
  • a lump or ulcer on the tonsil  

Any of the above can occur with a ‘normal’ mouth or throat infection but it is the persistence of them after a three or four-week period which should raise concern and trigger a trip to the GP.